Is Botox Right For You? By Dr. Sylvia Ramirez, MD MPH MBA
Botox treatment is the most common aesthetic procedure in the world. Its popularity results from its effectiveness in restoring a youthful appearance without any downtime. This article gives you facts and details about Botox to remove the mystery and myths about this treatment.
What is Botox?
Botox is a brand name for botulinum toxin, a highly purified protein which is injected in very small doses to reduce or eliminate wrinkles. The other brand available in Singapore known as “Dysport” works in exactly the same way. For the purposes of this article, we will call botulinum toxin as “Botox” but the treatment and effects are the same with “Dysport”.
The US FDA, which is the organization in the US that approves the use of medications in the US based on scientific evidence and safety profile, has approved Botox for use in certain medical conditions since the 1980s. Its effectiveness for reducing wrinkles was discovered more recently, where patients receiving Botox for lazy eye were also found to have fewer wrinkles. Since then, doctors have been using Botulinum toxin for cosmetic purposes.
How does it work?
Botox temporarily blocks the signal from a nerve to a muscle. The treated muscles are weaker, so that the wrinkle formed by muscle contraction relaxes and softens. Because of its mechanism of action, Botox works best for lines that are formed because of muscle contraction such as frown lines and horizontal forehead lines, as well as crow’s feet.
Botox treatment lasts three to six months. Lines and wrinkles gradually reappear as Botox wears off. With repeated treatments, doctors have observed that Botox may last longer as the muscles become less prominent from non-use.
Wrinkles resulting from gravity or sun damage, as well as pigments or laxity are not treated by Botox. Other laser or light treatments may be used alone or in combination with Botox to address these other related concerns.
What are the clinical uses of Botox?
Botox is used to treat wrinkles that form because of repeated muscle contraction. These include muscles used for frowning, smiling, concentrating or thinking. These usually present as horizontal lines on the forehead, or grooves between the eyebrows, as well as smile lines (crow’s feet) around the eyes. Botox is also used to lift the eyebrows (“brow lift”), make the eyes appear rounder, and to correct lines around the lips and necks. In Singapore and the rest of Asia, a common use for Botox is to “slim” the lower face when it is injected on the muscles we use for chewing (“masseter muscle”) along the angles of the jaw.
There are other non-cosmetic uses of Botox including reduction of excessive underarm or palm sweating (hyperhydrosis”), the treatment of headaches, and the management of spastic conditions.
How is the procedure performed?
A Botox treatment takes only a few minutes. You can come in to talk to the doctor, have the treatment, then go straight back to work without downtime. The treatment will weaken only the muscles that produce wrinkles so your natural facial expressions will not be affected.
Tiny amounts of Botox are injected into specific muscles and because a very fine needle is involved, it is almost “pain-free”. Some patients may ask for a little numbing cream but most people describe the treatment as like a little “ant bite”.
If you’re considering a Botox treatment, tell the doctor what medications you are on since some medications (for example aspirin) may increase the risk of bruising. The injection usually takes three to 7 days to take effect and the doctor may ask you to pop in after a week to assess the results. The doctor may also ask you to use the muscles that are injected so that the Botox takes effect in the right areas. You will also be asked to avoid lying down for a few hours.
What are the side effects of Botox?
The most common side effect of this treatment is temporary bruising. You may also feel a temporary headache. If Botox spreads outside of the muscles being treated, there may be temporary eyelid drooping in a small percentage of patients. This is why the doctor will ask you not to rub the treated area for several hours and not to lay down for a few hours.
Who should not receive Botox?
Botox should not be administered in patients who are pregnant, are breastfeeding, or have a neurologic condition. Also, because wrinkles formed because of other factors may not be treated by Botox, it is important to have a detailed consultation with a doctor.
What other treatments should I consider?
Since aging may present with wrinkles, pigments, pores, and skin laxity, Botox is often combined with other effective and proven skin treatments to regain a more youthful looking skin. Examples include non-ablative and minimally ablative lasers (such as the Pearl laser resurfacing device) which may be beneficial in treating wrinkles that cannot be reduced by Botox. Skin tightening treatments such as the Titan can stimulate collagen growth thus improving skin laxity.
When it comes to skin rejuvenation, every person has unique concerns and individual needs. If you are looking for a treatment for wrinkles or other skin concerns, talk to a doctor about which procedure is right for you. Nothing can replace a doctor’s professional advice.
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3 Jul 09 at 2:22 am
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Alice
25 Nov 09 at 5:12 am
Dear Alice,
thank you for your feedback. Please let us know if you would like to see some specific topics covered on our blog.
Take care,
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cutislaser
14 Dec 09 at 11:39 pm
Sure, how does this work?
cutislaser
14 Dec 09 at 11:43 pm
I would like to know whether can dark eye rings can be treated? Not just lighten…..
Lian
12 Aug 10 at 11:14 am
Dear Lian,
success for treating dark eye rings largely depends on the cause for it. A Visia Complexion Analysis (http://www.visia-complexion-analysis.com) will allow us to determine underlying causes of your dark circles and recommend appropriate treatments – if any. Please call 6327 9700 to set up an appointment.
cutislaser
14 Oct 10 at 7:49 pm
There are some interesting time limits in this article however I don’t know if I see all of them heart to heart. There’s some validity however I’ll take hold opinion till I look into it further. Good article , thanks and we want more! Added to FeedBurner as effectively
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10 Feb 11 at 10:50 am
Hi Doctor,
How long will the botox effect for the slimming of the jaw last?
How much will it cost as well?
Thanks soo much for answering! = D
Regards,
Agnes
Agnes
20 Feb 11 at 9:50 pm
Dear Agnes, cost for jaw slimming largely depends on the size of your masseter muscle (which can make the jaw look squarish) and hence the number of botox units required. Usually, between 40 and 60 units of botox are required. We charge S$ 16/unit with a reduction in price for 50 units and above. Usually our patients would do the jaw reduction treatment twice a year for the first couple of years and then reduce it to every 9 months or so. Please call 6327 9700 for more information. Thank you for your interest in our services. Your Cutis Team
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